Around the world, many efforts are being made to reform child welfare systems to promote better care for children. As articulated by the Guidelines for the Alternative Care of Children, such reform should involve greater support to families to prevent a loss of parental care and efforts to provide quality alternative family-based care for children who cannot be with their parents. This paper aims to convince those who are developing and implementing such policies that they should place support for children with disabilities and their families at the heart of reform efforts, and to demonstrate, through examples, how this can be achieved.